|
| |
|
593 Eddy Street Providence RI 02903 | |
| (401) 444-7442 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 593 Eddy Street, Providence, Rhode Island |
| Authorized Official Name and Position | Peter K Markell (EVP & CFO) |
| Authorized Official Contact | 4014447914 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
117 Ellenfield St Ste 101 Providence RI 02905-4541 Ph: (401) 444-6779 | 593 Eddy Street Providence RI 02903 Ph: (401) 444-7442 |
| NPI Number | 1548506793 |
|---|---|
| Provider Enumeration Date | 12/17/2012 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/18/2024 |
| Medicare PECOS PAC ID | 2567455082 |
|---|---|
| Medicare Enrollment ID | O20130528000089 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548506793 | NPI | - | NPPES |
| Provider Name | Laura Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548274038 PECOS PAC ID: 4981598034 Enrollment ID: I20040210001060 |
| Provider Name | Deborah M Robitaille |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447562830 PECOS PAC ID: 6901888155 Enrollment ID: I20040602001170 |
| Provider Name | Maria L Buckley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487632634 PECOS PAC ID: 3375520513 Enrollment ID: I20040706000622 |
| Provider Name | Gerald M Tarnoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881600153 PECOS PAC ID: 2961480587 Enrollment ID: I20040710000043 |
| Provider Name | Gloria T Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376572651 PECOS PAC ID: 1254319353 Enrollment ID: I20040713001117 |
| Provider Name | Abbe L Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881670529 PECOS PAC ID: 0941274328 Enrollment ID: I20040823000217 |
| Provider Name | Norman E Weitzberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225075492 PECOS PAC ID: 9537142971 Enrollment ID: I20041023000063 |
| Provider Name | Jeffrey M Burock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023096278 PECOS PAC ID: 4486616588 Enrollment ID: I20041101000761 |
| Provider Name | Sharon L Vessella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235158437 PECOS PAC ID: 9739144510 Enrollment ID: I20041122000046 |
| Provider Name | Gabor I Keitner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346224953 PECOS PAC ID: 0648221184 Enrollment ID: I20050202000460 |
| Provider Name | Elizabeth E Flynn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841220613 PECOS PAC ID: 3870545171 Enrollment ID: I20050215000662 |
| Provider Name | Christopher D Houck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821074576 PECOS PAC ID: 6709833361 Enrollment ID: I20050405001363 |
| Provider Name | Debbie Mendelsohn |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1215915228 PECOS PAC ID: 2466499611 Enrollment ID: I20050411000195 |
| Provider Name | Jeffrey P Wincze |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184601932 PECOS PAC ID: 8325081987 Enrollment ID: I20050603001042 |
| Provider Name | Horacio Hojman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558345512 PECOS PAC ID: 3678514460 Enrollment ID: I20051011000066 |
| Provider Name | Christine I Trendell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528195914 PECOS PAC ID: 8820004815 Enrollment ID: I20060228000703 |
| Provider Name | Christine L Trask |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558347997 PECOS PAC ID: 2668420043 Enrollment ID: I20060317000030 |
| Provider Name | Jeanne Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174588875 PECOS PAC ID: 2466463252 Enrollment ID: I20060508000749 |
| Provider Name | Jody A Underwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528003712 PECOS PAC ID: 5496759292 Enrollment ID: I20060911000186 |
| Provider Name | Mandy Witkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871694943 PECOS PAC ID: 5991704637 Enrollment ID: I20061207000178 |
| Provider Name | Nebyou Belay |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1194810507 PECOS PAC ID: 2860491032 Enrollment ID: I20061216000077 |
| Provider Name | Catherine Noble Heart |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1831134469 PECOS PAC ID: 2769482603 Enrollment ID: I20061228000084 |
| Provider Name | Daphne Koinis- Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932143229 PECOS PAC ID: 4688674146 Enrollment ID: I20070105000441 |
| Provider Name | Emily R Katz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710058656 PECOS PAC ID: 4284634551 Enrollment ID: I20070110000493 |
| Provider Name | Maureen Mckone |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1336215664 PECOS PAC ID: 7416958608 Enrollment ID: I20070131000372 |
| Provider Name | Holly Manning |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588792790 PECOS PAC ID: 4082712195 Enrollment ID: I20070612000770 |
| Provider Name | Cristina Toba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215151329 PECOS PAC ID: 9830299130 Enrollment ID: I20070716000745 |
| Provider Name | Kathleen R Donise |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134257348 PECOS PAC ID: 3971694779 Enrollment ID: I20070808000663 |
| Provider Name | Heather M Hall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407918030 PECOS PAC ID: 7416042593 Enrollment ID: I20071004000294 |
| Provider Name | April Cambre |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578788691 PECOS PAC ID: 2062500325 Enrollment ID: I20071120000360 |
| Provider Name | Kristy L Dalrymple |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750579355 PECOS PAC ID: 1153411665 Enrollment ID: I20071220000649 |
| Provider Name | Christopher M Matkovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699933382 PECOS PAC ID: 0042385536 Enrollment ID: I20080819000005 |
| Provider Name | Elizabeth A Lowenhaupt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699972372 PECOS PAC ID: 6406923960 Enrollment ID: I20080925000004 |
| Provider Name | Arnaldo Adolfo Berges |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003853094 PECOS PAC ID: 5092786533 Enrollment ID: I20090624000052 |
| Provider Name | Elizabeth L Mcquaid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114903820 PECOS PAC ID: 9931254638 Enrollment ID: I20090902000011 |
| Provider Name | Jamison E Rogers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790906089 PECOS PAC ID: 6709931256 Enrollment ID: I20090904000119 |
| Provider Name | Nicole R Nugent |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851527659 PECOS PAC ID: 3274689997 Enrollment ID: I20090922000632 |
| Provider Name | Jennifer Wolff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962643700 PECOS PAC ID: 9537215256 Enrollment ID: I20090922000641 |
| Provider Name | Melissa A Buttaro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508094590 PECOS PAC ID: 1254478597 Enrollment ID: I20091020000122 |
| Provider Name | Wade C Myers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578677894 PECOS PAC ID: 7810913035 Enrollment ID: I20091103000010 |
| Provider Name | Deborah E Carranza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700119062 PECOS PAC ID: 1153460548 Enrollment ID: I20091124000346 |
| Provider Name | Jennifer B Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407832769 PECOS PAC ID: 9931237609 Enrollment ID: I20100518000021 |
| Provider Name | Tina Sheff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801811260 PECOS PAC ID: 2466583927 Enrollment ID: I20100627000015 |
| Provider Name | Colin J Harrington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922083153 PECOS PAC ID: 6103958483 Enrollment ID: I20100722000224 |
| Provider Name | Jennifer L Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710963004 PECOS PAC ID: 8921131640 Enrollment ID: I20100802000855 |
| Provider Name | Richard M Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558345488 PECOS PAC ID: 6800929522 Enrollment ID: I20100802000904 |
| Provider Name | Iwona Chelminski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457337776 PECOS PAC ID: 1254464845 Enrollment ID: I20100803000826 |
| Provider Name | William C Lafrance |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649254251 PECOS PAC ID: 7810020427 Enrollment ID: I20100803001065 |
| Provider Name | Karen Fullerton |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1306822176 PECOS PAC ID: 1850424474 Enrollment ID: I20100803001164 |
| Provider Name | Naureen M Attiullah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023092889 PECOS PAC ID: 3173656790 Enrollment ID: I20100803001231 |
| Provider Name | Daniela Boerescu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386628154 PECOS PAC ID: 6608909130 Enrollment ID: I20100804000025 |
| Provider Name | Larry K Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326022369 PECOS PAC ID: 3173656675 Enrollment ID: I20100804000943 |
| Provider Name | Margaret M Mannix |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124276126 PECOS PAC ID: 9032302161 Enrollment ID: I20101021001074 |
| Provider Name | Jennifer E Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063498996 PECOS PAC ID: 4486847217 Enrollment ID: I20101025000695 |
| Provider Name | William A Chase |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780660092 PECOS PAC ID: 2769675503 Enrollment ID: I20101025000805 |
| Provider Name | Marcia Liss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922039353 PECOS PAC ID: 6406035807 Enrollment ID: I20110131000641 |
| Provider Name | Megan Pinkston Camp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447560487 PECOS PAC ID: 7113100389 Enrollment ID: I20110325000010 |
| Provider Name | Jocelyn J Lahaye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154425221 PECOS PAC ID: 1456361815 Enrollment ID: I20110523000464 |
| Provider Name | Lucille B Mehring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992914808 PECOS PAC ID: 8224206792 Enrollment ID: I20110728000019 |
| Provider Name | Matthew D Willis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912125345 PECOS PAC ID: 8729258264 Enrollment ID: I20110819000189 |
| Provider Name | Karen T Cammuso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720026412 PECOS PAC ID: 8123299609 Enrollment ID: I20110913000432 |
| Provider Name | Henry T Sachs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952349821 PECOS PAC ID: 3678744166 Enrollment ID: I20110913000557 |
| Provider Name | Karen A Holler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750474599 PECOS PAC ID: 0042356404 Enrollment ID: I20111020000703 |
| Provider Name | Lisa B Shea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033125356 PECOS PAC ID: 7012183999 Enrollment ID: I20111226000009 |
| Provider Name | Luisa Skoble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003820432 PECOS PAC ID: 0749175743 Enrollment ID: I20120113000617 |
| Provider Name | Farrel I Klein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447364559 PECOS PAC ID: 5395902043 Enrollment ID: I20120208000009 |
| Provider Name | Sarah Hagin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821378662 PECOS PAC ID: 8527226471 Enrollment ID: I20120222001090 |
| Provider Name | Jon E Brett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235262346 PECOS PAC ID: 8729247663 Enrollment ID: I20120312000737 |
| Provider Name | Carmen Monzon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902839285 PECOS PAC ID: 1456513530 Enrollment ID: I20120507000743 |
| Provider Name | Jeffrey I Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952357998 PECOS PAC ID: 6709033194 Enrollment ID: I20120820000580 |
| Provider Name | Laura A Stanton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851596712 PECOS PAC ID: 1456508936 Enrollment ID: I20120906000443 |
| Provider Name | Lindsay M Orchowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417228255 PECOS PAC ID: 1658520697 Enrollment ID: I20121005000556 |
| Provider Name | David C Ahern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821352527 PECOS PAC ID: 1052563822 Enrollment ID: I20121203000033 |
| Provider Name | Jennifer K Trayner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508029455 PECOS PAC ID: 8628221769 Enrollment ID: I20130123000394 |
| Provider Name | Sandhya M Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164583779 PECOS PAC ID: 5799888756 Enrollment ID: I20130807001012 |
| Provider Name | Sydney S Moon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114954583 PECOS PAC ID: 5890799712 Enrollment ID: I20130820000301 |
| Provider Name | Benjamin D Lederer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346258209 PECOS PAC ID: 0840451126 Enrollment ID: I20130909000022 |
| Provider Name | Janet L Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619116993 PECOS PAC ID: 1355575663 Enrollment ID: I20130927000384 |
| Provider Name | Selby M Conrad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831275056 PECOS PAC ID: 9739313727 Enrollment ID: I20131007000024 |
| Provider Name | Tanya B Tran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093130338 PECOS PAC ID: 5193942274 Enrollment ID: I20140813002040 |
| Provider Name | Michael R Walther |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093121394 PECOS PAC ID: 4587882246 Enrollment ID: I20140822000128 |
| Provider Name | Joanna V Maclean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568786077 PECOS PAC ID: 1456571140 Enrollment ID: I20140930003104 |
| Provider Name | Emily E Murphy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659501377 PECOS PAC ID: 5395965099 Enrollment ID: I20141001000180 |
| Provider Name | Ernestine G Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154731743 PECOS PAC ID: 9830412790 Enrollment ID: I20141229001306 |
| Provider Name | Zoe R Billinkoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407167497 PECOS PAC ID: 4082938642 Enrollment ID: I20150130001652 |
| Provider Name | Janessa O Carvalho |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689860611 PECOS PAC ID: 9830327980 Enrollment ID: I20150203000115 |
| Provider Name | Stephanie L Rickerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790183069 PECOS PAC ID: 4183940372 Enrollment ID: I20150305001873 |
| Provider Name | Meesha Ahuja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881905875 PECOS PAC ID: 0941521025 Enrollment ID: I20150601001928 |
| Provider Name | Margaret Bublitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982099784 PECOS PAC ID: 3375854235 Enrollment ID: I20150618001091 |
| Provider Name | Justin Schleifer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801107743 PECOS PAC ID: 2668787268 Enrollment ID: I20150811005355 |
| Provider Name | Harold Arthur Woodcome |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922362466 PECOS PAC ID: 1355657966 Enrollment ID: I20150827001313 |
| Provider Name | Anastasia M Wermert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417277328 PECOS PAC ID: 7214155290 Enrollment ID: I20150914000327 |
| Provider Name | Alison W Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124046511 PECOS PAC ID: 6204939614 Enrollment ID: I20151007001088 |
| Provider Name | Shannon L Terkell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386958346 PECOS PAC ID: 1052530334 Enrollment ID: I20151009001248 |
| Provider Name | Kirsten J Langdon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629454285 PECOS PAC ID: 4183933823 Enrollment ID: I20151021000912 |
| Provider Name | Jennifer Jencks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063764652 PECOS PAC ID: 6002125424 Enrollment ID: I20151026000123 |
| Provider Name | Jared Minkel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104253566 PECOS PAC ID: 4486885746 Enrollment ID: I20151027001915 |
| Provider Name | David J Mysels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982755088 PECOS PAC ID: 3577688829 Enrollment ID: I20160311000540 |
| Provider Name | Steven J Barreto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336180983 PECOS PAC ID: 6608174123 Enrollment ID: I20160418001251 |
| Provider Name | Anna E Schierberl Scherr |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235594797 PECOS PAC ID: 0547554131 Enrollment ID: I20160804000585 |
| Provider Name | Michael D Mcquiggan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437413986 PECOS PAC ID: 9133423080 Enrollment ID: I20160901000621 |
| Provider Name | Sarah B Schmidhofer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053759381 PECOS PAC ID: 0941439681 Enrollment ID: I20160909001772 |
| Provider Name | Jeniimarie Febres |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417203837 PECOS PAC ID: 3173811916 Enrollment ID: I20161012000246 |
| Provider Name | Clifford Bromberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699712489 PECOS PAC ID: 4284914722 Enrollment ID: I20161129002065 |
| Provider Name | Emily S Rowland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295174373 PECOS PAC ID: 0345545091 Enrollment ID: I20170210000408 |
| Provider Name | Anupriya Gogne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609135342 PECOS PAC ID: 4688951908 Enrollment ID: I20170515000869 |
| Provider Name | Seth A Clark |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1801208798 PECOS PAC ID: 3870710213 Enrollment ID: I20170626001451 |
| Provider Name | Denise M. Crooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619499795 PECOS PAC ID: 4880965953 Enrollment ID: I20170808001621 |
| Provider Name | Loreen Phyllis Carol Pirnie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013355312 PECOS PAC ID: 6901179977 Enrollment ID: I20170913003253 |
| Provider Name | Justyna Piasecka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003106360 PECOS PAC ID: 4981977964 Enrollment ID: I20170913003818 |
| Provider Name | Jason Richard Rafferty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104186089 PECOS PAC ID: 9234358813 Enrollment ID: I20170928004257 |
| Provider Name | Alyssa Beth Pullan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366983314 PECOS PAC ID: 7012282528 Enrollment ID: I20171010001721 |
| Provider Name | Yovanska M Duarte Velez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356714919 PECOS PAC ID: 5294001780 Enrollment ID: I20171028000000 |
| Provider Name | Philip Julian Schmitt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316993975 PECOS PAC ID: 3971520248 Enrollment ID: I20180115000010 |
| Provider Name | Daniella Palermo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407269210 PECOS PAC ID: 3870897739 Enrollment ID: I20180305001511 |
| Provider Name | Michelle D Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922488469 PECOS PAC ID: 0749583896 Enrollment ID: I20180307000226 |
| Provider Name | Kelley Anne Nelligan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053430702 PECOS PAC ID: 8224390059 Enrollment ID: I20180315000206 |
| Provider Name | Kristyn N Storey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346653904 PECOS PAC ID: 4587966262 Enrollment ID: I20180327001666 |
| Provider Name | Sarah E Ouellette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225468267 PECOS PAC ID: 4385905819 Enrollment ID: I20180327002597 |
| Provider Name | Amy Egolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619234341 PECOS PAC ID: 3779878012 Enrollment ID: I20180625003011 |
| Provider Name | Rachel Ojserkis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124516208 PECOS PAC ID: 8820344203 Enrollment ID: I20180628000596 |
| Provider Name | Brittney Boykin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316289754 PECOS PAC ID: 5991004905 Enrollment ID: I20180712001176 |
| Provider Name | Seth Aaron Margolis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952819484 PECOS PAC ID: 9638426224 Enrollment ID: I20180730000375 |
| Provider Name | Barbara M Ruf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093129330 PECOS PAC ID: 7113222860 Enrollment ID: I20180802000545 |
| Provider Name | Christine Michele Leddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003173048 PECOS PAC ID: 7315295235 Enrollment ID: I20180808002285 |
| Provider Name | Jamie Gainor Dipietro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740627702 PECOS PAC ID: 8921303686 Enrollment ID: I20180809000896 |
| Provider Name | Janine Galione |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164908935 PECOS PAC ID: 7113277963 Enrollment ID: I20180829001564 |
| Provider Name | Teresa E Daniels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497102529 PECOS PAC ID: 2365723004 Enrollment ID: I20180829003751 |
| Provider Name | Marc Jonathan Perkel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932337748 PECOS PAC ID: 2769735802 Enrollment ID: I20181019000353 |
| Provider Name | Gina M Marini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699289389 PECOS PAC ID: 8123364320 Enrollment ID: I20190109001041 |
| Provider Name | Chrystal Vergara-lopez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932676806 PECOS PAC ID: 9133465826 Enrollment ID: I20190117001181 |
| Provider Name | Donald Marc Laliberte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174974547 PECOS PAC ID: 5698016350 Enrollment ID: I20190405000319 |
| Provider Name | Caitlin S Lawrence |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629458047 PECOS PAC ID: 1153626809 Enrollment ID: I20190424002716 |
| Provider Name | Alyssa Lynne Norris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609431444 PECOS PAC ID: 0941533558 Enrollment ID: I20190613003081 |
| Provider Name | Aryandokht Fotros |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447665831 PECOS PAC ID: 3274866728 Enrollment ID: I20190614001938 |
| Provider Name | Bonny H Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215371257 PECOS PAC ID: 3173899408 Enrollment ID: I20190628002015 |
| Provider Name | Sarah Catherine Pillemer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336608843 PECOS PAC ID: 2466787247 Enrollment ID: I20190716003001 |
| Provider Name | Caroline A Wunsch |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1629427265 PECOS PAC ID: 6204120314 Enrollment ID: I20190719001855 |
| Provider Name | Tanuja P Gandhi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023365707 PECOS PAC ID: 0749574184 Enrollment ID: I20190726001998 |
| Provider Name | Aditi Vikas Hajirnis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962686220 PECOS PAC ID: 0042546178 Enrollment ID: I20190729000404 |
| Provider Name | Sibel Alev Algon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891851648 PECOS PAC ID: 8224290143 Enrollment ID: I20190806002524 |
| Provider Name | Meghan Sharp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841784485 PECOS PAC ID: 5991137192 Enrollment ID: I20191108001034 |
| Provider Name | Jennifer Evelyn Salerno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366086860 PECOS PAC ID: 1658704085 Enrollment ID: I20191125002870 |
| Provider Name | Christine M Nunes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245528421 PECOS PAC ID: 8224397286 Enrollment ID: I20191218001486 |
| Provider Name | Elizabeth H Brannan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699095687 PECOS PAC ID: 6507292026 Enrollment ID: I20200131002046 |
| Provider Name | Matthew M Sheehan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194171777 PECOS PAC ID: 9830477355 Enrollment ID: I20200609000868 |
| Provider Name | Nicholas Tarantino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467090456 PECOS PAC ID: 6305267881 Enrollment ID: I20200609002554 |
| Provider Name | Erin Elizabeth O'connor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871113001 PECOS PAC ID: 9830511872 Enrollment ID: I20200622001772 |
| Provider Name | Von Marie Rodriguez-guzman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831505163 PECOS PAC ID: 2668895707 Enrollment ID: I20200708003098 |
| Provider Name | Ingrid Lauer Arnold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609255280 PECOS PAC ID: 3173829249 Enrollment ID: I20200731000351 |
| Provider Name | Sarah Herrick Morris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720602410 PECOS PAC ID: 4587080619 Enrollment ID: I20200819002072 |
| Provider Name | Elizabeth Courtney Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184257586 PECOS PAC ID: 2668899808 Enrollment ID: I20200902000892 |
| Provider Name | Mohamed Amr Sherif |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477784122 PECOS PAC ID: 4688092893 Enrollment ID: I20200918001811 |
| Provider Name | Kathryn A Simon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023671799 PECOS PAC ID: 0941629182 Enrollment ID: I20201007002287 |
| Provider Name | Jessica Mccurry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063869287 PECOS PAC ID: 0143640417 Enrollment ID: I20201027000104 |
| Provider Name | Ryann A, Morrison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447788286 PECOS PAC ID: 7214347228 Enrollment ID: I20201103001170 |
| Provider Name | Laura Elizabeth Korthauer Gilmour |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689299661 PECOS PAC ID: 9133539000 Enrollment ID: I20201104000530 |
| Provider Name | Jacob Adrian Lafo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326659012 PECOS PAC ID: 9638589278 Enrollment ID: I20201110000973 |
| Provider Name | Rachel Weitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982210977 PECOS PAC ID: 3971913369 Enrollment ID: I20201114000067 |
| Provider Name | Christina Marie Mele |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932758927 PECOS PAC ID: 9234540667 Enrollment ID: I20201116002056 |
| Provider Name | Helen Day |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366966723 PECOS PAC ID: 4385055987 Enrollment ID: I20201203002162 |
| Provider Name | Christina J Bellanti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508813791 PECOS PAC ID: 0941611495 Enrollment ID: I20201204001249 |
| Provider Name | Kimberly Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578168936 PECOS PAC ID: 1850705369 Enrollment ID: I20210125001497 |
| Provider Name | Ornella Judith Potter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023212792 PECOS PAC ID: 4082028519 Enrollment ID: I20210125002335 |
| Provider Name | Alyssa Nicole Orlandi |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255927836 PECOS PAC ID: 3678981768 Enrollment ID: I20210408001640 |
| Provider Name | Hanna Kathryn Bjork |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134707821 PECOS PAC ID: 7517376247 Enrollment ID: I20210511000665 |
| Provider Name | Petya Dimitrova Radoeva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588084743 PECOS PAC ID: 0749570398 Enrollment ID: I20210519001978 |
| Provider Name | Haitham Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487175188 PECOS PAC ID: 2668871153 Enrollment ID: I20210603002215 |
| Provider Name | Caroline Joy Golski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205356599 PECOS PAC ID: 3678846789 Enrollment ID: I20210604002370 |
| Provider Name | Michelle Lopes Alves |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1598188732 PECOS PAC ID: 4284034687 Enrollment ID: I20210607000935 |
| Provider Name | Shiwen Yuan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780104141 PECOS PAC ID: 3577836683 Enrollment ID: I20210701002866 |
| Provider Name | Russell Morgan Marks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447834569 PECOS PAC ID: 2567864168 Enrollment ID: I20210706000275 |
| Provider Name | Alaa Elnajjar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194170647 PECOS PAC ID: 8628470994 Enrollment ID: I20210708002157 |
| Provider Name | Mitch C Otu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154785061 PECOS PAC ID: 3577897008 Enrollment ID: I20210723002110 |
| Provider Name | Timothy Steinhoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619356193 PECOS PAC ID: 3870809379 Enrollment ID: I20210806000156 |
| Provider Name | Laura Grace Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841553724 PECOS PAC ID: 6002210135 Enrollment ID: I20210811001268 |
| Provider Name | Jason M Andreas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568994739 PECOS PAC ID: 8022366426 Enrollment ID: I20210816000565 |
| Provider Name | Gregory Paul Stiener |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033270459 PECOS PAC ID: 3577968072 Enrollment ID: I20210821000098 |
| Provider Name | Jennifer A Cueto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386092765 PECOS PAC ID: 4082019435 Enrollment ID: I20210823002045 |
| Provider Name | Cecilia Fix |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1679991806 PECOS PAC ID: 5092088773 Enrollment ID: I20210825000545 |
| Provider Name | Katherine F Visser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285214783 PECOS PAC ID: 5597160549 Enrollment ID: I20210830001000 |
| Provider Name | Charles Alexander Brake |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558941963 PECOS PAC ID: 5890191720 Enrollment ID: I20210901001470 |
| Provider Name | Dana B Goetz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619556826 PECOS PAC ID: 7810393030 Enrollment ID: I20210913002623 |
| Provider Name | Kristin S. Knapp-ines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659537033 PECOS PAC ID: 1355747502 Enrollment ID: I20210914000324 |
| Provider Name | Anna Leticia Villavicencio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538299904 PECOS PAC ID: 5890191928 Enrollment ID: I20210915000136 |
| Provider Name | Andrew C. Martina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891157442 PECOS PAC ID: 7618227687 Enrollment ID: I20210915001199 |
| Provider Name | Dana Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841766987 PECOS PAC ID: 1557768470 Enrollment ID: I20210920003167 |
| Provider Name | Victoria Elena Marques |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316527468 PECOS PAC ID: 8224436480 Enrollment ID: I20211001002886 |
| Provider Name | Melissa Mcwilliams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275127458 PECOS PAC ID: 1951709112 Enrollment ID: I20211001002905 |
| Provider Name | Christina Marie D'angelo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962074476 PECOS PAC ID: 3274921002 Enrollment ID: I20211028001344 |
| Provider Name | Kathryn Basques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982954160 PECOS PAC ID: 0345558557 Enrollment ID: I20211208000368 |
| Provider Name | Maria Del Pilar Trelles Thorne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558505891 PECOS PAC ID: 8426329038 Enrollment ID: I20220110002083 |
| Provider Name | Bethany Rallis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538837950 PECOS PAC ID: 5395137855 Enrollment ID: I20220113002428 |
| Provider Name | Jose Arauz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659825693 PECOS PAC ID: 4486046877 Enrollment ID: I20220114001538 |
| Provider Name | Karin Camara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528526415 PECOS PAC ID: 3678987823 Enrollment ID: I20220208002393 |
| Provider Name | Danielle Brot |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255930186 PECOS PAC ID: 8921492661 Enrollment ID: I20220223001911 |
| Provider Name | Diane E Mclean |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336114693 PECOS PAC ID: 7012163843 Enrollment ID: I20220224002376 |
| Provider Name | Lindsay Paige Huffhines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740933514 PECOS PAC ID: 6901290261 Enrollment ID: I20220302001367 |
| Provider Name | Bryana Elizabeth Killion |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063171015 PECOS PAC ID: 0840685673 Enrollment ID: I20220315000351 |
| Provider Name | Chelsea Kopacz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063710333 PECOS PAC ID: 6709271802 Enrollment ID: I20220325001847 |
| Provider Name | Jessica Fresh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679093629 PECOS PAC ID: 3173910023 Enrollment ID: I20220425001816 |
| Provider Name | Hannah Elizabeth Frank |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164173944 PECOS PAC ID: 3971990409 Enrollment ID: I20220430000012 |
| Provider Name | Karyn J Horowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578502233 PECOS PAC ID: 6901283266 Enrollment ID: I20220507000149 |
| Provider Name | Brooke Dewitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518468792 PECOS PAC ID: 1254718158 Enrollment ID: I20220516000812 |
| Provider Name | Gisela Gabriela Jimenez Colon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396228961 PECOS PAC ID: 8123405867 Enrollment ID: I20220518000779 |
| Provider Name | Farhad Amani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689056632 PECOS PAC ID: 0648584086 Enrollment ID: I20220523000278 |
| Provider Name | Karen Marlene Jennings Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689954893 PECOS PAC ID: 1355652686 Enrollment ID: I20220609001440 |
| Provider Name | Rachel Joy Herman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679212948 PECOS PAC ID: 3072994292 Enrollment ID: I20220720000544 |
| Provider Name | Jayne Shadlyn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447773445 PECOS PAC ID: 2961765334 Enrollment ID: I20220725002486 |
| Provider Name | Denise Labelle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760859524 PECOS PAC ID: 6305195041 Enrollment ID: I20220728001767 |
| Provider Name | Dylan Hershkowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922538644 PECOS PAC ID: 3577836600 Enrollment ID: I20220804001594 |
| Provider Name | Kira Keenan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306358825 PECOS PAC ID: 6002298205 Enrollment ID: I20220804002276 |
| Provider Name | Jyllian Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649862863 PECOS PAC ID: 0446633689 Enrollment ID: I20220819002325 |
| Provider Name | Cassandra Ann Gibson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265969430 PECOS PAC ID: 1557638541 Enrollment ID: I20220912003248 |
| Provider Name | Rachel M Depner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841948049 PECOS PAC ID: 9234514944 Enrollment ID: I20220916000795 |
| Provider Name | Pamela Alida Scalise |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407216369 PECOS PAC ID: 2860877016 Enrollment ID: I20220923002177 |
| Provider Name | Jennifer Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700375870 PECOS PAC ID: 6507242682 Enrollment ID: I20220927000931 |
| Provider Name | Melissa Pielech |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881076586 PECOS PAC ID: 0547646390 Enrollment ID: I20220930001476 |
| Provider Name | Elizabeth Wagner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831629336 PECOS PAC ID: 4385914563 Enrollment ID: I20221006001606 |
| Provider Name | Joseph Michael Donahue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043872682 PECOS PAC ID: 3779969241 Enrollment ID: I20221006001900 |
| Provider Name | Amanda S. Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619590726 PECOS PAC ID: 9537588827 Enrollment ID: I20221104000323 |
| Provider Name | Maggie Azar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568198315 PECOS PAC ID: 3577930361 Enrollment ID: I20221108001795 |
| Provider Name | Katherine Bellesheim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508405275 PECOS PAC ID: 2264809060 Enrollment ID: I20221108002402 |
| Provider Name | Michela Muggeo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295211043 PECOS PAC ID: 5092063529 Enrollment ID: I20221108002431 |
| Provider Name | Ilse Deyanira Carrizales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962844894 PECOS PAC ID: 5092183558 Enrollment ID: I20221115001859 |
| Provider Name | Kathryn Ann Lachance |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710501606 PECOS PAC ID: 5799153326 Enrollment ID: I20221201001821 |
| Provider Name | Tess Marie Cagenello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407591894 PECOS PAC ID: 6608246327 Enrollment ID: I20221221001148 |
| Provider Name | Erik Hood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376149534 PECOS PAC ID: 9436529542 Enrollment ID: I20230106001297 |
| Provider Name | Shivana Naidoo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366769093 PECOS PAC ID: 2062727209 Enrollment ID: I20230111000988 |
| Provider Name | Nicholas Ivan Kendrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154762136 PECOS PAC ID: 7113397985 Enrollment ID: I20230112001511 |
| Provider Name | Kimberly Rodrigues |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538586979 PECOS PAC ID: 9931570801 Enrollment ID: I20230201001155 |
| Provider Name | Christa J.m. Belgrave |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164942793 PECOS PAC ID: 3476826512 Enrollment ID: I20230206002145 |
| Provider Name | Ashley Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780068866 PECOS PAC ID: 0648681767 Enrollment ID: I20230228001796 |
| Provider Name | Sarah Brandwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508476003 PECOS PAC ID: 9739552308 Enrollment ID: I20230301001172 |
| Provider Name | Alison Manning |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376980425 PECOS PAC ID: 6305066002 Enrollment ID: I20230306001506 |
| Provider Name | Trisha Arnold |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366053803 PECOS PAC ID: 1658747944 Enrollment ID: I20230424002475 |
| Provider Name | Victoria Anne Montagano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134823420 PECOS PAC ID: 4587029152 Enrollment ID: I20230503003292 |
| Provider Name | Elizabeth Meryl Olsen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437644135 PECOS PAC ID: 5092064782 Enrollment ID: I20230516001424 |
| Provider Name | Rachel Hunt Olfson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710477542 PECOS PAC ID: 0941667125 Enrollment ID: I20230602000516 |
| Provider Name | Federico Gomez Bernal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881191765 PECOS PAC ID: 6901154756 Enrollment ID: I20230608000242 |
| Provider Name | Jared Au Yeung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376103200 PECOS PAC ID: 5193052983 Enrollment ID: I20230620001523 |
| Provider Name | Rachel Ruderman Looff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578122412 PECOS PAC ID: 5496082240 Enrollment ID: I20230626001780 |
| Provider Name | Chijioke Nnanna Egbujo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164601548 PECOS PAC ID: 9830484005 Enrollment ID: I20230705001711 |
| Provider Name | Micheline Ruth Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861187676 PECOS PAC ID: 6709246549 Enrollment ID: I20230712002251 |
| Provider Name | Mostafa Zakaria Khalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811540651 PECOS PAC ID: 5698135648 Enrollment ID: I20230721002218 |
| Provider Name | Vicenta Hudziak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598257842 PECOS PAC ID: 4385999820 Enrollment ID: I20230725002254 |
| Provider Name | Samantha Marie Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528562303 PECOS PAC ID: 6709137599 Enrollment ID: I20230728000407 |
| Provider Name | Emily Federo Hungria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184120073 PECOS PAC ID: 9234488206 Enrollment ID: I20230731000561 |
| Provider Name | Amy Jeanne Rasmussen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053848234 PECOS PAC ID: 9032488689 Enrollment ID: I20230802002268 |
| Provider Name | Camila Cosmo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982181715 PECOS PAC ID: 4688903552 Enrollment ID: I20230807001965 |
| Provider Name | Laura Elizabeth Fischer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851096648 PECOS PAC ID: 3971965971 Enrollment ID: I20230808001490 |
| Provider Name | Zachary Michael Lane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760971337 PECOS PAC ID: 9537521075 Enrollment ID: I20230815001665 |
| Provider Name | Andrea Gaul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578098828 PECOS PAC ID: 2466871983 Enrollment ID: I20230816001070 |
| Provider Name | Jessica Soto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275064305 PECOS PAC ID: 4688946692 Enrollment ID: I20230818001948 |
| Provider Name | Cassidy Cooper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063944007 PECOS PAC ID: 9133493109 Enrollment ID: I20230821003920 |
| Provider Name | Emily Margaret May |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962106880 PECOS PAC ID: 3072976786 Enrollment ID: I20230829001784 |
| Provider Name | Jessica Brooke Hanratty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932881133 PECOS PAC ID: 5698139657 Enrollment ID: I20230911001630 |
| Provider Name | Alison Goldblatt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063908861 PECOS PAC ID: 6406200674 Enrollment ID: I20230922000527 |
| Provider Name | Kelli Lynn Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659060333 PECOS PAC ID: 5092169979 Enrollment ID: I20230926002909 |
| Provider Name | David Lichtenstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043892649 PECOS PAC ID: 4587060678 Enrollment ID: I20231005001806 |
| Provider Name | Rebecca Lee Troeger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487340451 PECOS PAC ID: 6002261112 Enrollment ID: I20231010001887 |
| Provider Name | Marisa Bergfield Michiels |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225604861 PECOS PAC ID: 1254786023 Enrollment ID: I20231013002193 |
| Provider Name | Courtnie Beaubian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982058350 PECOS PAC ID: 7416303391 Enrollment ID: I20231030000468 |
| Provider Name | Gabriela Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124710926 PECOS PAC ID: 2062869977 Enrollment ID: I20231115001105 |
| Provider Name | Hannah Herc |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952925331 PECOS PAC ID: 1658729066 Enrollment ID: I20231126000074 |
| Provider Name | Liani Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962805960 PECOS PAC ID: 5294183232 Enrollment ID: I20231130003169 |
| Provider Name | Amy Joyce Kaye |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437551017 PECOS PAC ID: 4284083932 Enrollment ID: I20231207000763 |
| Provider Name | Vivien Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902566177 PECOS PAC ID: 3870989718 Enrollment ID: I20231207001647 |
| Provider Name | Zachary Joseph Langevin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588205496 PECOS PAC ID: 6800220195 Enrollment ID: I20231208003267 |
| Provider Name | Salma Khshaiboon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063871895 PECOS PAC ID: 4082919477 Enrollment ID: I20231208003305 |
| Provider Name | Cazzie Es Steinzor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780252148 PECOS PAC ID: 0244689495 Enrollment ID: I20231213000789 |
| Provider Name | Kimberly Rose Chapman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821655226 PECOS PAC ID: 5294184305 Enrollment ID: I20231214003386 |
| Provider Name | Kathryn Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295459444 PECOS PAC ID: 1052761731 Enrollment ID: I20231220003600 |
| Provider Name | Kathleen Reilly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417659962 PECOS PAC ID: 9830540053 Enrollment ID: I20240111002708 |
| Provider Name | Shannon M. Pine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427671478 PECOS PAC ID: 7113378308 Enrollment ID: I20240112000186 |
| Provider Name | Stephanie Shoppell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063862027 PECOS PAC ID: 0143671347 Enrollment ID: I20240112000452 |
| Provider Name | Sarah Ann Zimage |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891245668 PECOS PAC ID: 2668824756 Enrollment ID: I20240112004122 |
| Provider Name | Timothy Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952924813 PECOS PAC ID: 8224480397 Enrollment ID: I20240115001130 |
| Provider Name | Kenneth W Lafountain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497957674 PECOS PAC ID: 2264884519 Enrollment ID: I20240123000562 |
| Provider Name | Jamie Amanda Turcotte |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679111926 PECOS PAC ID: 2466805429 Enrollment ID: I20240126001014 |
| Provider Name | Melissa J Weaver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952759615 PECOS PAC ID: 6507209145 Enrollment ID: I20240209003502 |
| Provider Name | Krisha Corbo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790163970 PECOS PAC ID: 1951745355 Enrollment ID: I20240213004047 |
| Provider Name | Alissa Mary Forleo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659062420 PECOS PAC ID: 0042654618 Enrollment ID: I20240222001212 |
| Provider Name | Susan Aubut |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760628945 PECOS PAC ID: 4880039031 Enrollment ID: I20240228001139 |
| Provider Name | Melissa Mckenna |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114671609 PECOS PAC ID: 4284070327 Enrollment ID: I20240311003601 |
| Provider Name | Jennifer Stockwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518440122 PECOS PAC ID: 7810334596 Enrollment ID: I20240318003529 |
| Provider Name | Danielle Cohn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629560180 PECOS PAC ID: 7214342039 Enrollment ID: I20240320003312 |
| Provider Name | Rachel Bailey-moore |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679355143 PECOS PAC ID: 9830536788 Enrollment ID: I20240327001394 |
| Provider Name | Jena Gordon Talbot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821511338 PECOS PAC ID: 5395182158 Enrollment ID: I20240328001784 |
| Provider Name | Carlee A. Maynard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679326748 PECOS PAC ID: 1557701075 Enrollment ID: I20240501002637 |
| Provider Name | Molly Braga |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518212422 PECOS PAC ID: 4880035823 Enrollment ID: I20240508003212 |
| Provider Name | Nicholas Cerbo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407341670 PECOS PAC ID: 5193166619 Enrollment ID: I20240515003123 |
| Provider Name | Meghan Christine Savina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093964942 PECOS PAC ID: 4981864410 Enrollment ID: I20240521001697 |
| Provider Name | Kristen Wesbecher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942837885 PECOS PAC ID: 1456770791 Enrollment ID: I20240522000339 |
| Provider Name | James W Jewett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710688577 PECOS PAC ID: 9830631019 Enrollment ID: I20240603003164 |
| Provider Name | Grace Cushman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881459931 PECOS PAC ID: 1355883984 Enrollment ID: I20240611000153 |
| Provider Name | Anastacia Y. Kudinova |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316786668 PECOS PAC ID: 3476096918 Enrollment ID: I20240625001361 |
| Provider Name | Judith Mccullough Romero |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326164732 PECOS PAC ID: 2668517848 Enrollment ID: I20240730000151 |
| Provider Name | Justin Preston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467290411 PECOS PAC ID: 5597202192 Enrollment ID: I20240731003834 |
| Provider Name | Shereen Khoo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679126346 PECOS PAC ID: 4183162860 Enrollment ID: I20240813000905 |
| Provider Name | Maya A Marzouk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063167096 PECOS PAC ID: 1951840057 Enrollment ID: I20240903001145 |
| Provider Name | Kayla Sall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689419327 PECOS PAC ID: 0042750630 Enrollment ID: I20240910002842 |
| Provider Name | Conner James Black |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700652948 PECOS PAC ID: 6406387992 Enrollment ID: I20241008003745 |
| Provider Name | Shalini Kansal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538620935 PECOS PAC ID: 9335579820 Enrollment ID: I20241015000531 |
| Provider Name | Michelle Aiello |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740065705 PECOS PAC ID: 6800328493 Enrollment ID: I20241021003884 |
| Provider Name | Yvorn Aswad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013560887 PECOS PAC ID: 2062945496 Enrollment ID: I20241024000219 |
| Provider Name | Sarah F Joelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174370449 PECOS PAC ID: 2668905001 Enrollment ID: I20241024000423 |
| Provider Name | Elizabeth Tampke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053985853 PECOS PAC ID: 1456885797 Enrollment ID: I20241111000039 |
| Provider Name | Stephanie L Ross |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487032728 PECOS PAC ID: 4486920212 Enrollment ID: I20241114002152 |
| Provider Name | Kayla Behbahani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053730150 PECOS PAC ID: 3779709738 Enrollment ID: I20241118002324 |
| Provider Name | Lingyue Lu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427707348 PECOS PAC ID: 9234664400 Enrollment ID: I20241125002138 |
| Provider Name | Anna Jang Yeo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215778626 PECOS PAC ID: 7810423282 Enrollment ID: I20241209002061 |
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